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I l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '2.(0l� < Ct�(a2 S Z — <br /> PROJECTADDRE38 <br /> O�-t�N g.f�STF./� L�.J�3 Zfo<<t L.,p�¢ ST 6v2I'TT kiA4B�c� 4ZS 2,yt-y 7 <br /> Owner MellAddroas City Stete2lp Phone <br /> 5 /�1-L� <br /> Tenenl MailAddroes City Stete2ip Phone <br /> �� � p� � re�c 3Sc] S�d�rr.TSi •cuaotErT u.ia A9��.v► yz� iSL-4�i 7 <br />. Elecl�lce'I C M�aclo� Mail Addresa City State2lp Phone <br /> ,l„� i �T ' Lr�oxNl:t _ - <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contect Pereon (Plan Review) <br /> Square Footega(I(residenllel new constructlon, remodel or addition) <br /> Descrlpllon o(Work to Be Done: Y� � P �YL,�_____!��_����/� � �J� Sf�SI�i�C �Ci,�T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � �D . 00 <br /> CITY OF EVERETT LOCAL SALES TAX CODE 19 910b <br /> 1 hereby ceRily(het I have read and exemined(his epplicefion and know Ihe same to be frue end � <br /> correcf. All provlslons ollaws end ordinances govem/ng fhis type o/work wfll be complefed k �Z o`� -D(� <br /> whefl�er specifred hereln or nol. The granfing ol a permif does notp resume to give authority fo <br /> vlolete or cancel fhe provislons ol eny ofher sfafe orlocellew repuleting consfructlon or fhe <br /> peilormance o/consfruction. Thaf I am aufhorized by tho owner ol fhlsFropeAy to peAorm the <br /> work lor whlch eppllcaflon Is made end I camply with fhe Slefe Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> / �//�w�I/�� l/�/� � ��� I�i7n <br /> ���"° g.9� ate <br />